At House hearing, Price defends NIH cuts and offers few details on plans for ACA

HHS Secretary Price testifies in front of the House Appropriations Labor, Health and Human Services Subcommittee on Wednesday.

Under questioning from Congress members Wednesday, Department of Health and Human Services Secretary Tom Price defended planned funding cuts to the National Institutes of Health and said his agency would uphold the Affordable Care Act as long as it’s the law.

President Donald Trump’s proposed budget for 2018 would cut HHS funding by $15 billion. NIH would see a $5.8 billion cut as well as a “major reorganization” of its institutes and centers. Some have raised concerns that those cuts would harm biomedical research as well as hamper precision medicine initiatives.

But during the House subcommittee hearing, Price argued that the Trump administration is simply trying to get “more bang for our buck” out of HHS.

“I was struck by the need for efficiencies in decreasing duplication and the like within our entire department,” he said.

For example, about 30% of NIH’s grant money is used for indirect expenses, meaning that money isn’t going toward research, he said. He also pointed out that NIH currently comprises about a third of the discretionary budget for HHS, and that ratio is maintained under Trump’s proposal.

Price vague about ACA plans

In response to questions about his agency’s plans for administering the ACA, Price said that when it comes to enforcing certain rules like the individual mandate, “so long as the law is on the books, we in the department are obliged to uphold the law.”

But noting that he is now named as the defendant in a lawsuit that challenges the legality of cost-sharing reduction (CSR) payments, Price refused to comment on whether the Trump administration would—or should—choose to continue funding those subsidies.

If the administration does decide to halt funding for CSRs, it could profoundly destabilize the ACA marketplaces, as it could spur many insurers to decide to stop offering coverage next year.

Price did acknowledge that he has met with insurers across the country that have said they are “extremely concerned” about the future of the marketplaces and whether they can continue offering coverage.

“That’s why we believe it’s imperative we move in a direction that allows individuals the greatest opportunity to have the choices in the coverage they receive,” he said.

Price was similarly circumspect about whether HHS and the Trump administration intended to repeal the ACA or strengthen and improve it.

“The department, the administration is committed to making certain that the American people have access to affordable coverage,” he said, later adding, “We believe the current law has harmed many individuals.”